Opinions on what the outbreak suggests in China's cases of the coronavirus

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SINGAPORE (Reuters) – A new diagnostic method has led the Chinese province to the epicenter of a coronavirus outbreak to report a record increase in deaths and thousands more cases on Thursday.
The central province of Hubei had previously only allowed infections to be confirmed by RNA tests, which can take days to process.

But it has begun to use faster computed tomography (CT), which reveals lung infections, to confirm cases of viruses, health officials said.
Here are the comments of some experts on the importance of the jump in numbers.

DR. EYAL LESHEM, CLINICAL ASSOCIATE TEACHER, TEL AVIV UNIVERSITY MEDICINE SCHOOL, ISRAEL:

"I think the other very new issue that will be very hot is that China is changing the case definition."
"The Chinese added the suspicious cases to the count and I believe that the data on the severity of the disease can be affected, because what we are seeing is that as the denominator grows substantially and the number of deaths does not grow, then we can possibly discover this disease is less lethal than we initially thought. "
On the data of the World Health Organization on deaths by province:

"The province of Hubei, the epicenter of the disease, reported more than 1,000 deaths from 33,000 cases. However, all other provinces have reported fewer than 10 deaths and several hundred cases."
"So it seems that the death rate in Hubei is much higher than in other provinces.
"And one way of looking at this data is that in Hubei, the medical system was overwhelmed by the cases and could only evaluate serious hospitalized patients.
"And … other provinces proved milder cases. And the real mortality of the disease rate may be less than 2% that we see in the reports."

QI XIAOLONG, MEDICINE TEACHER, FIRST HOSPITAL OF THE UNIVERSITY OF LANZHOU, GANSU, CHINA:

The change in the way cases are counted reflects a local policy in Hubei to promote early detection and early isolation, he said, adding:

"The case data would not be timely if Hubei uses the nucleic acid test only to confirm the cases, because patients there, without enough test kits and test personnel, must wait days to get a result."

"Meanwhile, the quality of the kit and the sampling error will lead to a probability of false negative. The person with false negative could be the mobile source of infection in the community."

Outside of Hubei, Qi said there was no urgent need to change the methodology, since the number of patients was lower, and nucleic acid tests could still reflect the precise situation in a timely manner.

Qi added that he did not believe that the number of recently confirmed cases would show a peak in the near future, and predicted that the combined number of confirmed cases and clinical diagnosis would remain stable, or even decrease.

PROFESSOR CHOI JAE-WOOK, PRESIDENT, SCIENTIFIC REVIEW COMMITTEE, KOREA MEDICAL ASSOCIATION (KMA):

"I suppose that the reason why the Chinese health authorities decided to change the diagnostic procedure by including the clinical diagnosis is because they lack diagnostic kits, which delays the treatment of those with symptoms.

"And since only a few companies are manufacturing these test kits in such a short time, the authorities cannot trust their quality."

"I don't think the measure has been delayed much. We are still in the initial stage of the epidemic."

"The health authorities in South Korea also discussed the adoption of the clinical diagnosis last week. If they do, there will be many more suspected cases of virus patients."

READ SEOK-WON, SOUTH KOREA CENTERS FOR DISEASE CONTROL AND PREVENTION (KCDC):

"CT scans may be faster in producing results than our current RT-PCR method using RNA amplification techniques, but it can only determine if it was pneumonia, not if it is the new coronavirus.

"China seems to have decided to use CT scans to resolve cases of pneumonia more quickly, given the rapid spread of the virus and the high probability of getting it."

DR. ANOOP KUMAR A.S., HEAD, CRITICAL CARE MEDICINE, BABY MEMORIAL HOSPITAL, INDIA:

"Although Hubei says they can process up to 6,000 samples per day, the sample size may be excessive.

"The problem is that there are many other viral pneumonias with almost similar characteristics in China, so it cannot be said with 100% accuracy that the cases identified in this way are the coronavirus itself.

"In that case, we could be overestimating the number of cases and underestimating the number of deaths.

"Another thing is that if you make the diagnosis or not, you are basically receiving symptomatic treatment, there is no specific antiviral at all.

"Therefore, only for surveillance purposes will your diagnosis make a difference.

"As for the jump in cases, it is difficult to comment, since we have no data on how many laboratories confirmed or those (which were) confirmed by radiology."

"This methodology can be used in places where they have a large number of cases that cannot be processed using other methods."

"What the world has to think about is that we will have to obtain more machines from & # 39; point of attention & # 39 ;, which will allow rapid processing of the samples, WHO or international agencies will have to think about mobilizing that" .

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